Provider Demographics
NPI:1629360508
Name:WANG, WENBAO (MD)
Entity type:Individual
Prefix:
First Name:WENBAO
Middle Name:
Last Name:WANG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2460 N INTERSTATE 35 E RD
Mailing Address - Street 2:SUITE 265
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165
Mailing Address - Country:US
Mailing Address - Phone:469-800-9740
Mailing Address - Fax:469-800-9741
Practice Address - Street 1:2460 N INTERSTATE 35 E RD
Practice Address - Street 2:SUITE 265
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165
Practice Address - Country:US
Practice Address - Phone:469-800-9740
Practice Address - Fax:469-800-9741
Is Sole Proprietor?:No
Enumeration Date:2011-05-10
Last Update Date:2025-10-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXR05212081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation